Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu 210006, China.
Chin Med J (Engl). 2009 Sep 20;122(18):2092-6.
Stenting a bifurcation lesion is technically challenging. No study has reported the clinical outcome of a dedicated bifurcation stent in China. We aimed to analyze the safety and clinical outcome of a novel side branch ostial stent (BIGUARD) stent in treating coronary bifurcation lesions.
Forty-seven patients were enrolled in this first-in-man study, with 61.7% true bifurcation lesions (0,1,1 and 1,1,1) and 26.7% diabetes. A two-stent technique was used in 27.6% of the patients, and 64.7% of patients crossed from the one-stent technique to the two-stent arm. Clinical and angiographic follow-up data at 12 months were available in all the 47 patients and in 43 patients (91.9%), respectively. The study endpoint was the occurrence of major adverse cardiac events (MACE) at 12 months.
Only one patient had a non-ST segment elevation myocardial infarction, which led to 2% of the in-hospital composite MACE. Notably, the target lesion revascularization at 12 months was 8.6%, with a 10.6% composite MACE at 12 months. Neither cardiac death nor stent thrombosis was seen during the follow-up. By quantitative coronary analysis, the restenosis rate at the main vessel and ostium of the side branch was 9.4% and 2.1%, respectively. Four of 12 patients (33.3%) treated with one-stent and kissing balloon inflation had restenosis in the main vessel.
BIGUARD stent was safe and feasible in treatment of bifurcation lesions.
分叉病变支架置入技术具有挑战性。尚无研究报道中国专用分叉支架的临床结果。我们旨在分析一种新型边支开口支架(BIGUARD)治疗冠状动脉分叉病变的安全性和临床结果。
共有 47 例患者入组本项首例患者研究,其中 61.7%为真性分叉病变(0、1、1 和 1、1、1),26.7%为糖尿病患者。27.6%的患者采用双支架技术,64.7%的患者从单支架技术转为双支架技术。所有 47 例患者和 43 例(91.9%)患者均获得了 12 个月的临床和血管造影随访数据。研究终点为 12 个月时主要不良心脏事件(MACE)的发生。
仅 1 例患者发生非 ST 段抬高型心肌梗死,导致住院期间复合 MACE 发生率为 2%。值得注意的是,12 个月时靶病变血运重建率为 8.6%,12 个月时复合 MACE 发生率为 10.6%。随访期间无心脏死亡或支架血栓形成。定量冠状动脉分析显示,主血管和边支开口的再狭窄率分别为 9.4%和 2.1%。12 例采用单支架和对吻球囊扩张治疗的患者中,有 4 例(33.3%)主血管发生再狭窄。
BIGUARD 支架治疗分叉病变安全可行。